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Student Registration Form .pdf



Original filename: Student-Registration-Form.pdf
Title: Student Registration Form
Author: CEMurray@cbe.ab.ca

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Student Registration Form

CBE ID #:

Student Information System (SIS)

Program:
Full-day Kindergarten:

This form must be completed for all new students who are registering in a
Calgary Board of Education (CBE) school (K-12).

Address Verified:

Yes

Yes

No
No

Entered by:

Date:

STUDENT INFORMATION (Please print)

YYYY/MM/DD

DECLARATION OF RESIDENCY
The student named below is a resident of the Calgary Board of Education as defined by the School Act.
See Student Residency and Important Information for Parents on page 4 of this form.
Has the student named below ever registered in a Calgary Board of Education (CBE) school?

Yes

No

Yes

If yes, name the last CBE school attended

No

Last Grade
Completed

CBE Student ID Number

School Withdrawal Date

Alberta Education ID Number

YYYY

MM

DD

The student’s Birth Certificate, Canadian Citizenship Certificate, Passport, Visa, Permanent Landed Immigrant document or other official document
must be given along with this form in order to register. A photocopy will be placed in the Official Student Record.
Name of official document (specify)
Student’s Legal Name

Student’s AKA Name (name by which the student
is commonly known in the family and community)

Surname

AKA Surname

First Name

AKA First Name

Birthdate
YYYY

MM

DD

Middle Name
Gender

Female

Male

Other / Prefer not to disclose

Address

City

Phone Number

Unlisted

Postal Code

Quadrant of City (please select one)
NW

Listed

NE

SW

Residential District
SE

MEDICAL INFORMATION (Note: The CBE is not allowed to collect Alberta Health Care numbers as per the Health Information Act.)
If the student’s attendance at school may be affected by an existing medical or physical condition, it is your responsibility to complete and submit the
Student Health Plan that is available from the school or online at www.cbe.ab.ca.
Does your child have any medical or physical conditions that may affect his/her attendance at school?

Yes

No

If yes, please give a brief description
Have you completed the Student Health Plan?

Yes

No

SCHOOL INFORMATION
Name of school at which student is registering

Grade Entering

Start Date
MM

YYYY
Name of last school attended

Grade Completed

Reason for leaving last school

Was the student suspended or expelled from the last school?
If yes, was the suspension resolved?
Yes
No

Yes

No

If the suspension has been resolved, provide further information.

(If the suspension has not been resolved, CBE staff will refer to Student Services-Suspensions)
Address of last school (If outside CBE)

City

Postal Code

Phone number of last school

Country

DD

Province

Fax number of last school
Office Use Only

SIS

Revised December 2016

Fees

Codes
Legal Services

Request Records
Page 1 | 5

INDEPENDENT STUDENT STATUS
Students 18 years of age and older, or “independent” under the School Act:
Any student 18 years of age and older or 16 years of age and older and considered legally “independent” under CBE policy may complete this form and register in
the Calgary Board of Education School District without parental consent. Proof of independent status must be presented.
Are you declaring independent status?

Yes

No

If yes, please attach proof of independent status.

PARENT/GUARDIAN INFORMATION

This information must be provided. Please provide a minimum of TWO emergency contacts.

1

Mother

Father

Legal Guardian

Stepmother

Stepfather

Other ________

Ms.

Mr.

Sole Custody

Miss

Mrs.

Dr.

Shared/Joint Custody/Guardian.

Is this person an EMERGENCY contact?
Last Name

2

Yes

Mother

Father

Legal Guardian

Stepmother

Stepfather

Other ________

Ms.
Access

No

Mr.

Sole Custody

Miss

Last Name

Address

Dr.

Shared/Joint Custody/Guardian.

Is this person an EMERGENCY contact?

First Name

Mrs.

Access

Yes

No

First Name

Address

City

Province

Postal Code

Country

City

Province

Postal Code

Country

Home Phone Number

Business Phone Number

Home Phone Number

Business Phone Number

Cellular Phone Number

Fax Number

Cellular Phone Number

Fax Number

Email

Email

3

Mother

Father

Legal Guardian

Stepmother

Stepfather

Other ________

Ms.

Mr.

Sole Custody

Miss

Mrs.

Dr.

Shared/Joint Custody/Guardian.

Is this person an EMERGENCY contact?
Last Name

Yes

Mother

Father

Legal Guardian

Stepmother

Stepfather

Other ________

Ms.

Access
No

Mr.

Sole Custody

Miss

First Name

Mrs.

Dr.

Shared/Joint Custody/Guardian.

Is this person an EMERGENCY contact?
Last Name

Address
City

4

Access

Yes

No

First Name

Address
Province

Postal Code

Country

City

Province

Postal Code

Country

Home Phone Number

Business Phone Number

Home Phone Number

Business Phone Number

Cellular Phone Number

Fax Number

Cellular Phone Number

Fax Number

Email

Email

CUSTODY OR GUARDIANSHIP INFORMATION
Student PRIMARILY lives with
e.g., Mother, Father, Legal Guardian, Stepmother, Stepfather, other (specify)
If a custody order or any other legal document governing the custody or guardianship of your child exists, a copy or the most recent custody document
must be placed in the student record.
Attach copy

Name and date of most current legal document
NAME

Revised December 2016

Legal Services

YYYY/MM/DD

Page 2 | 5

SIBLING INFORMATION (Optional)
The provision of sibling information is optional and is collected for communication purposes.
Do you have other children attending CBE schools?

No

Yes

Name

If yes, please list name(s), school(s) and grade(s)

Grade

Name

School Attending

Grade

School Attending

Name

Grade

Name

School Attending

Grade

School Attending

CHILD CARE PROVIDER (If applicable)
Name
Phone Number(s)

Home _________________________

Business _______________________

Cell ___________________________

Email

CITIZENSHIP
Is the named student a Canadian citizen?

Yes

No

Birth country, if not Canada __________________________________________________

Citizenship, if not Canadian
Permanent Resident/Landed Immigrant
Child of a Canadian Citizen

Student Authorization – Study Permit

Refugee Claimant

Refugee Category ___________

Child of a lawfully admitted permanent or temporary resident

Study Permit Expiry Date
YYYY
MM
DD

Has your child been assessed by the CBE Admissions Office at Kingsland Centre?
Yes
No

ABORIGINAL SELF-IDENTIFICATION
If you wish to declare the student is Aboriginal, please select one:
First Nation (status)

First Nation (non-status)

Métis

Inuit

For further information, please refer to: www.education.alberta.ca/system-supports/results-reporting or contact Alberta Education at 780-427-8501.
If you have questions regarding the collection of student information by the Calgary Board of Education, please contact the Superintendent of Learning
at: learning@cbe.ab.ca

ENGLISH AS A SECOND LANGUAGE (ESL) ELIGIBILITY
A student may be eligible for ESL support when the language spoken mainly at home is a language other than English. ESL students can be Canadian born or
foreign born.
Do you think your child would benefit from ESL support?

Yes

No

Do you need assistance with interpretation?

Yes

No

Language mainly spoken at home ____________________________________________________________________________________________________

FRANCOPHONE ELIGIBILITY
The exercise of Francophone eligibility rights refers to instruction in a Francophone school, NOT a French Immersion school. According to the School Act and
Section 23 of the Canadian Charter of Rights and Freedoms, a student is eligible for instruction in a Francophone school if at least one parent is a Canadian citizen
and one of the following three conditions exists:




Either parent’s first language learned and still understood is French, or
Either parent has received their primary school instruction in Canada, in French, or
One or more of the parent’s children has received or is receiving primary or secondary instruction in French in Canada

Does your child have Francophone eligibility?

Yes

No

If yes, and you wish to exercise your right, please contact the Conseil Scolaire Du Sud de l’ Alberta at 403-686-6998. The Alberta Student Records Regulations
requires that, if requested, the CBE will provide name, address, birthdate, and parent’s name of Section 23 Eligible students to the Francophone School District.

Revised December 2016

Legal Services

Page 3 | 5

TRANSPORTATION
The Calgary Board of Education will provide subsidized transportation in accordance with CBE policy for students who attend their attendance area school or directed
school and who live within the transportation service area. The transportation service area means the designated zone within an attendance area in which the
Calgary Board of Education provides subsidized transportation. Bus contracts can be acquired at any CBE school, or online at www.cbe.ab.ca.

DECLARATION
I, the undersigned, hereby represent that I have the legal authority to register the child. I declare the information that I have provided on this form is complete and
accurate. I will notify the school of any changes to the information on this form. I have also read and understand the “School District Use of Personal
Information” section attached to this registration form. A copy of “Important Information for Parents” may be obtained from the school for future reference.
Registration Date

Signature of Custodial Parent / Legal Guardian / Independent Student
YYYY

MM

DD

STUDENT RESIDENCY

A student is considered to be a resident of the Calgary Board of Education if the custodial parent(s) / legal guardian(s) with day-to-day care of the
student reside in the City of Calgary and at least one of them is not of the Roman Catholic faith OR if the student is an independent student residing
in the City of Calgary and not of the Roman Catholic faith.
IMPORTANT INFORMATION FOR PARENTS

The personal information requested on this form as part of the school registration process is collected under the authority of Alberta’s Freedom of
Information and Protection of Privacy Act (FOIP), the School Act and its regulations, and the Canadian Charter of Rights and Freedoms, Section 23.
This information will be used for the establishment of a student record, determination of residency, for a school board’s obligation to provide students
with an education program that meets their needs, to provide a safe and secure school environment and other purposes that relate directly to and
are necessary for an operating program or activity, including program placement, determination of eligibility and/or suitability for provincial or federal
funding, contact and health related information in the event of problems or emergencies. Personal information may also be provided to the Minister
of Learning for the purpose of carrying out programs, activities, or policies under his/her administration (e.g., research, statistical analysis). This
information will be treated in accordance with the privacy protection provisions of the FOIP Act.

Revised December 2016

Legal Services

Page 4 | 5

OFFICE USE ONLY
Non-Resident student accepted until _______________________________________________________________________
Student Name

YYYY

CBE ID #

Date records sent for
MM
DD

Bus Eligibility
Yes
No
Bus Number _______________

Alberta Ed ID #

# French Hours

Data Entry Completed by
YYYY

Grade

Home Room

Date Completed
MM

DD

Copies received of:
Birth Certificate

Admissions Office Document

Proof of Citizenship

Custody or Guardianship

Student Health Plan

Proof of Independent Status

STUDENT REGISTRATION CODES
Code

Description

REGISTRATION ENTRY STATUS CODES (CHECK ONLY ONE BELOW)
100
Continuous Registration
200
New Registration (ECS) - (01)
310
Transfer In - CBE Jurisdiction
320
Transfer In - Alberta Jurisdiction
320
Transfer In – Calgary Catholic
320
Transfer In – Calgary Charter
320
Transfer In – Calgary Private
320
Transfer In – Virtual School
330
Transfer In - Inside Canada
340
Transfer In - Outside Canada
500
Return to Education
410
Drop-In - CBE Jurisdiction
411
Drop-In - CBE Jurisdiction - Health
412
Drop-In - CBE Jurisdiction - Work
420
Drop-In - Alberta Jurisdiction
421
Drop-In - Alberta Jurisdiction - Health
422
Drop-In - Alberta Jurisdiction - Work
430
Drop-In - Outside Alberta Jurisdiction
431
Drop-In - Outside Alberta - Health
432
Drop-In - Outside Alberta – Work
EXCEPTIONAL STUDENT CODES
ONLY WITH GRANTS PROGRAM - SPECIAL EDUCATION (500)
(EXCEPTIONAL STUDENT TYPES 1 & 2 ARE AVAILABLE)

10
ECS Development Immature
30
Mild/Moderate Disability (ECS)
47
Severe Delay Involving Language
41
Severe Cognitive Disability(ECS)
42
Severe Emotional/Behavioural Disability
43
Severe Multiple Disabilities
44
Severe Physical or Medical Disability
45
Deafness
46
Blindness
51
Mild Cognitive Disability
52
Moderate Cognitive Disability
53
Mild/Moderate Emotional/Behavioural Disability
54
Mild/Moderate Learning Disability
55
Mild/Moderate Hearing Disability
56
Mild/Moderate Visual Disability
57
Mild/Moderate Communication Disability
58
Mild/Moderate Physical or Medical Disability
59
Mild/Moderate Multiple Disability
70
Disabled Adult
80
Gifted and Talented
FRANCOPHONE ELIGIBILITY

ESL INITIAL EVALUATION INFORMATION

(SECTION 23 – CHARTER OF RIGHTS AND FREEDOMS)

A
B
C
Y

**Section 23 Information was not collected
**Section 23 ineligible (former code was N)
**Question was asked but eligibility is not known or not provided
Section 23 Eligible

Revised December 2016

Code
Description
ENROLMENT TYPE CODES
(ENROLMENT TYPES 1, 2 AND 3 ARE AVAILABLE)
121
Independent Student
330
Aboriginal Students Paid by Government
331
Aboriginal Learner – Status Indian/First Nation
332
Aboriginal Learner – Non-Status Indian/First Nation
333
Aboriginal Learner – Métis
334
Aboriginal Learner – Inuit
402
Resident - Exchange Outside Alberta but Inside Canada
403
Resident - Exchange Outside Canada
412
Exchange Outside Alberta but Inside Canada
413
Exchange Outside Canada
415
Visiting Outside Alberta but Inside Canada - Non-Funded
416
Visiting Outside Canada - Non-Funded
GRANTS PROGRAM CODE
(PROGRAM TYPES 1, 2 AND 3 ARE AVAILABLE)
110
Attend - Funding to Other
140
Education Services Agreement
211
Alternate French Language Program
230
French as a Second Language
301
Foreign-born ESL Funded
302
ESL Non-Funded
303
Canadian-born ESL Funded
401
Arabic Bilingual
403
Cree Bilingual
404
German Bilingual
405
Hebrew/Yiddish Bilingual
406
Ukrainian Bilingual
407
Polish Bilingual
408
Other Bilingual
409
Spanish Bilingual
410
Chinese Bilingual
412
Blackfoot Bilingual
550
Designated Institutional School (reside & attend)
600
Home Education
610
Home Education Blended Program
611
Home Education Portion of a Blended Program
612
In class Portion of a Blended Program
620
Online Program
630
Outreach Program
640
Refugee Student
710
Knowledge and Employability Courses (formerly IOP)

Legal Services

ACADEMIC CATEGORY
> 4 yrs. below age/grade level
3-4 yrs. below age/grade level
2-3 yrs. below age/grade level
1-2 yrs. below age/grade level
< 1 year below age/grade level
At /approaching age/grade level
Referral Date

ENGLISH PROFICIENCY LEVEL
ESL Literacy
Beginner
Intermediate 1
Intermediate 2
Advanced
No ESL Support
Assessment Date

Page 5 | 5

Notice to Parents
School District Use of Personal Information

cbe.ab.ca

Please keep for your records
The Calgary Board of Education (CBE) is authorized and required under the provisions of the School Act and its
regulations, in accordance with the Freedom of Information and Protection of Privacy Act (FOIP), to collect, use and
disclose the personal information necessary to provide an educational program and ensure a safe and secure school
environment for students. Consent is not required for these purposes.
Personal information means recorded information about an identifiable individual that may include but is not limited to:
student name, age, grade, address, phone number, etc. As part of the school’s digital citizenship plan, students will be
taught to limit, and consider the privacy implications, of sharing their personal information online.
The following are some examples of how personal information may be used by the CBE. This list is not intended to be
all-inclusive.
Student records, report cards, attendance
Photographs or videos ( e.g. individual, class, team, club) that feature students and are used within the school
n School newsletters, school websites
n Yearbooks, identification cards, library cards
n Classroom or program assignments and activities
n Assignment of a CBE Gmail account and the use of educational tools such as Google Apps* for Education, which
may require student information to log-in
n Parent/guardian contact information for absenteeism, emergencies, etc.
n Transportation services
n School-sponsored activities such as fine arts productions, presentations, fairs, celebrations, clubs, sports activities,
field trips
n To determine eligibility or suitability for an award, scholarship, athletic program, etc.
n Law enforcement and or matters relating to safety and security
n
n

* Gmail and G Suite for Education are used to communicate and collaborate electronically using Google Drive, Sites,
Groups, Gmail, Calendar, Photos and Keep. All other public and third party apps are not available through GAFE.
Parent/guardian consent is required for student information to be used for purposes beyond educational programming
and student safety. See the following forms on the CBE website (www.cbe.ab.ca)for more information:
n Consent for CBE Use of Student Information
n Consent for Use of Student Information by News Media and Outside Groups
Parents and independent students are under no obligation to provide consent by signing these forms. Consent may be
withdrawn at any time by notifying the school principal in writing.
If you have any questions about the collection or the intended uses of this information, please contact the school
principal.
Please note: Photos, videos or images of students attending or participating in school activities (e.g. sporting events,
concerts, cultural programs, clubs, field trips, graduation or other ceremonies), which are open to the public, may be taken
by anyone in attendance without prior consent. The CBE cannot control or prevent the further distribution or use of these
photos, videos, images or other personal information by those who access the information. Information posted online may
be transmitted to and stored on servers outside the CBE, including locations outside of Alberta and Canada. The CBE cannot
guarantee protection of information against possible disclosure resulting from illegal activity or under foreign access laws.

Frequently Asked Questions
Why is consent required?
The sharing of student personal information in ways that identify the student is governed by the Freedom
of Information and Protection of Privacy Act (FOIP) and requires CBE to obtain permission under certain
circumstances. CBE requires parental consent for CBE staff to share student information for educational purposes,
outside of CBE. Examples of this include posting student work or images on CBE websites, Facebook or other social
media. This consent is provided on the “Consent for CBE Use of Student Information” form
CBE also requires parental consent to allow third parties (such as media or business partners) to photograph,
video or interview students at CBE non public events. This consent is provided on the “Consent for Use of Student
Information by News Media and Outside Groups (Third Party)” form.

How long is my consent valid for?
Parental consent is gathered annually and is valid for the current school year only.

What happens if I change my mind regarding consent?
Parental consent can be withdrawn at any time during the school year. This must be done in writing to the school
principal. Please keep in mind that once personal information, images or student work are released in any public
forum, the CBE cannot control or prevent further distribution or use of the material. If you change your mind and
wish to provide consent during the school year, it must also be done in writing to the school principal.

What happens when the media comes to school?
If your child has consent, they may be recorded by the media. If you have not provided consent, your child will not
be allowed to be recorded or approached by the media on CBE property.

What is Gmail and G Suite for Education?
What is Gmail and G Suite for Education? Gmail and G Suite at CBE provide an online environment for students to collaborate and work in. The following Apps are available for students Google Drive, Sites, Groups, Gmail, Calendar, Photos
and Keep. There is no advertising and the information is not made public. Access to Gmail and G Suite for Education accounts and content is only for registered CBE students.

What is digital citizenship in relation to sharing student information?
Digital citizenship is about having the knowledge skills and attitudes needed to demonstrate responsible and
respectful behavior when participating in digital environments. This is applicable when students are asked to
provide personal information upon logging in to websites or sharing personal information online. All CBE schools
are required to have a digital citizenship plan.

THIS DOCUMENT IS FOR YOUR INFORMATION. PLEASE KEEP IT FOR YOUR RECORDS.

April 2017

Directions for Use of the Student Registration Form
This form is to be completed by independent students OR by the parents or legal guardians of students registering at Calgary Board of
Education schools.
1. Prior to registering any student, it must be determined if the student is a resident of the Calgary Board of Education as defined under
legislation. There is a space at the top of the Student Registration Form for the parent/guardian or independent student to declare
this information.
The School Act allows a board to set admission priorities where facilities or resources are not sufficient to accept all students wishing
to attend a specific school.
If there is space and resource limitations, the non-resident applicant must be informed that their registration cannot be
accommodated at that time. Non-resident students, whose registrations are accepted, must be informed in writing
regarding the duration of that acceptance.
Residency Considerations:
To qualify as a resident student of the CBE a student must physically reside within the jurisdiction of the Calgary Board of Education
(i.e., within the geographical boundaries of the CBE) with their parent(s) or legal guardian, or as an independent student. In addition,
the faith of the parent(s) of that student must be non-Catholic.
Out of Calgary Students

Roman Catholic Students

If the parents or legal guardians OR the independent status students live outside the geographic boundaries of the
Calgary Board of Education, they are not residents of the CBE.
If the parent(s) or the legal guardian(s) OR the independent status student live within the geographic boundaries of the
Calgary Board of Education but are of the Roman Catholic faith, the student is a resident of the Calgary Roman
Catholic Separate School Division and not resident of the CBE (School Act – Section 44(4))

Francophone Students

If the parent(s) or the legal guardian(s) OR the independent status student live within the geographic boundaries of the
Calgary Board of Education and the first language of the parents (or the Independent Student) is French AND they
wish to exercise their Section 23 rights, they are residents of the Conseils Scolaires Catholique et Francophones du
sud de l’Alberta and not residents of the CBE. If they do not wish to exercise their Section 23 rights, it must still be
determined if they are residents of the Calgary Board of Education or the Calgary Roman Catholic Separate School
Division.

Dual Residency

If both parents (or legal guardians) have care and custody of a student and each is a resident of a different school
district or division and they wish to have the student considered as a resident of the Calgary Board of Education, they
must declare that to be the case by checking YES to the Declaration of Residency and signing the Registration Form.
School Act - Section 44(8))

2. The custodial parents OR legal guardians OR independent student must complete the form and provide all required
documentation. Please note that full legal name is required. AKA given name may be requested and recorded in SIS.
3. Once the form is completed, review the form and documentation for completeness and accuracy with the person who completed it.
Pay particular attention to the declarations and supporting documents regarding residency, date of birth, citizenship, previous
suspension or expulsion, custody or guardianship, medical information, aboriginal information, ESL eligibility and francophone
eligibility. If medical information is provided, insure that follow-up forms are provided as necessary. Please note that provision of the
Alberta Personal Health Care Number cannot be required.
4. Add the student to SIS using Add a Student for Current Year or Add a Student for Next Year, whichever is appropriate. Transfer data
to SIS by entering information in the fields as they appear on the registration screens. On the top right hand corner of page 1, record
the student’s CBE ID # (if new to the Board), the Alternate or Special Education program name (if applicable), and if the student is
registering in Kindergarten, whether or not the program is a full-day Kindergarten program.
5. File the registration form and the supporting documents in the student’s cumulative file.

Once completed, the Student Registration Form becomes part of the CBE Official Student Record. Official student records may be
reviewed by either custodial/access parent and/or legal guardian. If the registering parent/guardian does NOT wish to have their
personal information (i.e. home address, work number etc.) shared with the other parent/guardian during a review of the student
record, a written request to keep this information private must be provided to the school.

Student Information System (SIS)


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